Association Between Telomere G-Tail Length and Coronary Artery Disease or Statin Treatment in Patients With Cardiovascular Risks　― A Cross-Sectional Study ―

Abstract

Background: The utility of telomere G-tail length to predict coronary artery disease (CAD) remains controversial. CAD results from coronary artery narrowing due to cholesterol and lipid accumulation, augmented by inflammatory cells and other factors. This study explored the significance of telomere G-tail length in suspected CAD patients. Methods and Results: In all, 95 patients with suspected CAD or ≥1 cardiac risk factor underwent coronary computed tomography angiography (CCTA). We measured leukocyte telomere length and G-tail length using a hybrid protection method, and diagnosed the presence of CAD using CCTA. Associations between G-tail length and the presence of CAD, the number of stenosed coronary arteries, and brachial-ankle pulse wave velocity (baPWV) were analyzed. No significant difference was observed in G-tail length when comparing groups with or without CAD or statin treatment. However, in the non-statin group, G-tail length was significantly shorter in patients with 3-vessel disease compared with 1-vessel disease. Dividing the group using a baPWV of 1,300 cm/s, telomere G-tail length was significantly shorter in the high-risk (baPWV ≥1,300 cm/s) group. Conclusions: The clinical utility of telomere G-tail length as a CAD risk indicator seems limited. There was a trend for longer telomere G‐tail length in the statin‐treated group. Moreover, telomere G-tail length was reduced in patients at high-risk of cardiovascular events, aligning with the trend of a shortening in telomere G-tail length with CAD severity.

Assessment of the relationship between telomere length and atherosclerosis: A Mendelian randomization study

“…Patients exhibiting telomere G-tail length shortening are at a heightened risk of cardiovascular events. [42] M Rafiq et al, through a case-control study with meta-analysis, demonstrated an association between LTL and the occurrence of CAD, suggesting its potential utility as a diagnostic and predictive marker for identifying CAD patients. [43] The research conducted by M Xiang et al indicates a correlation between LTL and reduced incidence of coronary heart disease.…”

Can statin preventative treatment inform geroscience‐guided therapeutics?

“…Indeed, several studies in the general population suggest that statins influence hallmarks of aging. For example, statins appear to improve endothelial function through alteration of epigenetic pathways (Liuzzo & Pedicino, 2023 ) and telomere attrition (Nose et al, 2023 ). Interestingly, the American College of Cardiology has recently suggested to consider the impact of geroscience on therapeutic strategies for older adult with cardiovascular disease (Forman et al, 2023 ).…”